Or. Admin. Code § 461-120-0345

Current through Register Vol. 63, No. 9, September 1, 2024

Section 461-120-0345 - Requirement to Cooperate with Division of Child Support and Obtain Cash Medical Support; OSIPM, QMB

This rule explains the obligation of individuals applying for or receiving benefits under the Oregon Supplemental Income Program Medical (OSIPM) or Qualified Medicare Beneficiaries (QMB) program to cooperate with the Division of Child Support and to obtain cash medical support for any individual receiving Medicaid under the state plan for which the individual can legally assign rights (see OAR 461-120-0310).

(1) Unless excused from the requirements of subsection (c) of this section or for good cause defined in OAR 461-120-0350:

(a) Individuals must cooperate with the Department and the Division of Child Support of the Department of Justice in establishing the identity of the parents (see OAR 461-001-0000) of any child (see OAR 461-001-0000) receiving Medicaid under the state plan for which the individual can legally assign rights.

(b) Individuals must cooperate with obtaining cash medical support.

(c) The Department may not refer a case for medical support enforcement when the referral is based solely on health care services provided through an Indian Health Program to a child who is eligible for health care services from the Indian Health Service.

(2) An individual who fails to meet an applicable requirement in section (1) of this rule is ineligible.

(a) In the case of an individual failing to meet the requirements of section (1) of this rule, the Department shall deny or close program benefits after providing the individual with notice and an opportunity to show good cause (see OAR 461-120-0350).

(b) The loss of eligibility does not apply to individuals who are not legally able to assign rights on behalf of themselves.

Or. Admin. Code § 461-120-0345

AFS 28-1992, f. & cert. ef. 10-1-92; AFS 19-1993, f. & cert. ef. 10-1-93; AFS 2-1994, f. & cert. ef. 2-1-94; AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95; AFS 30-1996, f. & cert. ef. 9-23-96; AFS 3-1997, f. 3-31-97, cert. ef. 4-1-97; AFS 19-1997, f. & cert. ef. 10-1-97; AFS 24-1997, f. 12-31-97, cert. ef. 1-1-98; AFS 10-1998, f. 6-29-98, cert. ef. 7-1-98; AFS 1-2000, f. 1-13-00, cert. ef. 2-1-00; AFS 17-2000, f. 6-28-00, cert. ef. 7-1-00; AFS 19-2001, f. 8-31-01, cert. ef. 9-1-01; AFS 27-2001, f. 12-21-01, cert. ef. 1-1-02; AFS 13-2002, f. & cert. ef. 10-1-02; SSP 1-2003, f. 1-31-03, cert. ef. 2-1-03; SSP 16-2003, f. & cert. ef. 7-1-03; SSP 29-2003(Temp), f. 10-31-03, cert. ef. 11-1-03 thru 3-31-04; SSP 33-2003, f. 12-31-03, cert. ef. 1-4-04; SSP 35-2003(Temp), f. 12-31-03 cert. ef. 1-1-04 thru 3-31-04; SSP 6-2004, f. & cert. ef. 4-1-04; SSP 17-2004, f. & cert. ef. 7-1-04; SSP 11-2007(Temp), f. & cert. ef. 10-1-07 thru 3-29-08; SSP 5-2008, f. 2-29-08, cert. ef. 3-1-08; SSP 29-2009(Temp), f. & cert. ef. 10-1-09 thru 3-30-10; SSP 38-2009, f. 12-31-09, cert. ef. 1-1-10; SSP 30-2013(Temp), f. & cert. ef. 10-1-13 thru 3-30-14; SSP 38-2013, f. 12-31-13, cert. ef. 1-1-14; SSP 25-2016(Temp), f. 6-30-16, cert. ef. 7-1-16 thru 12-27-16; SSP 31-2016, f. & cert. ef. 9/1/2016; SSP 44-2016, f. 12-7-16, cert. ef. 1/1/2017; SSP 14-2017, f. 6-5-17, cert. ef. 7/1/2017; SSP 26-2019, amend filed 12/27/2019, effective 1/1/2020; SSP 42-2022, temporary amend filed 07/18/2022, effective 7/18/2022 through 1/13/2023; SSP 50-2022, amend filed 09/30/2022, effective 10/1/2022; SSP 41-2024, amend filed 06/20/2024, effective 7/1/2024

Statutory/Other Authority: ORS 411.060, 411.070, 412.024, 412.049 & 414.042

Statutes/Other Implemented: ORS 411.060, 411.070, 412.001, 412.024, 412.049, 414.025, 414.042, 42 CFR 433.147, 42 CFR 435.610 & 42 USC 1396e-1